Pubdate: Sept 30, 1998 Source: New York Times (NY) Contact: http://www.nytimes.com/ Author: Christopher S. Wren WHITE HOUSE ENDORSES USE OF METHADONE NEW YORK---The White House's top drug policy official on Tuesday recommended expanding the availability of the drug methadone. General Barry McCaffrey outlined a major overhaul of federal methadone policy to treat heroin addiction in a speech to a national conference of the American Methadone Treatment Association in New York. The proposals by General McCaffrey, which incorporate suggestions from government agencies and other specialists in substance abuse, recommend that qualified physicians be allowed to administer methadone to patients in their offices. Methadone is now dispensed at special clinics. The times when it is dispensed can make it difficult for some recovering addicts to hold down jobs. General McCaffrey urged that methadone treatment be made available to any addict who requests and needs it. Methadone is used by 115,000 Americans addicted to heroin. They account for a fraction of the estimated 810,000 opiate addicts in the United States, some of whom cannot find treatment slots that would give them access to methadone. The administration intends to begin redrafting the federal regulations governing methadone in December or January. Officials said they doubted that congressional approval would be needed for any of the changes and foresaw no barriers at the federal level. States have wide control over the availability of methadone, however. New York state is the country's largest methadone provider. But eight statesdo not permit methadone clinics at all, forcing residents who feel they need it to travel to other states. The expectation is that a stronger endorsement of methadone's efficacy by the federal government will encourage comparable changes in at least some states. Among other changes, General McCaffrey urged that the Food and Drug Administration turn over the regulation of methadone to the Mental Health and Human Services Administration. He also suggested creating a comprehensive evaluation and accreditation system to assess methadone treatment at clinics, which vary widely in the quality and quantity of services. Mayor Rudolph Giuliani of New York City has sharply criticized methadone treatment. "I guess General McCaffrey has surrendered," Mr. Giuliani said Monday, "and essentially what he'd like to do is deal with heroin addiction by making people addicted to methadone, which maybe even is a worse addiction." - --- Checked-by: Rolf Ernst